We have been advised of a syndicate that sends bogus letters to healthcare service providers on medical scheme or administrator letterheads, allegedly from the finance department. These letters claim that an “erroneous payment” has been made into the healthcare provider’s bank account and request a refund of the money into a bank account that is supposedly a medical scheme or administrator account.
Please be advised that this is a scam. The payments that reflect in the healthcare provider’s account are actually stolen cheques that the syndicate deposits, which are subsequently rejected by the banks.
Some identifying features of these bogus refund letters:
• Poor spelling and grammar: these letters are usually badly written and contain spelling and grammatical errors.
• Questionable contact details: The only contact details provided are cellular telephone numbers.
• Requests to deduct banking charges: The letters usually request that banking charges are deducted before refunding.
Medical schemes and administrators do not conduct financial transactions in this way.
We are committed to assisting our member schemes in ensuring safe, ethical business practices at all times. The finance departments of medical schemes and administrators do not usually initiate any form of manual refund from healthcare providers for claim payments, payment errors, overpayments, etc. Where appropriate, corrections/reversals would be made electronically.
Some healthcare providers have already been exposed to this scam
In an attempt to expose this syndicate, one of the large administrators is working with some of the healthcare providers who have transferred money into these bank accounts after confirming the “overpayment” reflected in their own accounts.
If you believe you have been exposed to this scam or wish to provide any information about this, please contact our Forensic Management Unit co-ordinator, Lynette Swanepoel on 011 537 0227 or alternatively you may contact the Forensic Department of the relevant medical scheme or administrator.
